Resolved question:
Sir,on april 29th,2015 we had a baby girl.We went for ublicalcord blood cell preservation in Life cell interntional.Cord blood and Maternal blood preservation certificates (reports) we received today from life cell. In MATERNAL BLOOD report CMV IgG -POSITIVE.I studied in internet mother is effected by CMV IgG will effect the new born.We didnt carried out NEW BORN SCREENING TEST.Is it required to carryout New born screening test to know the effect on baby.Are any other tests are required to carry out to know the healthiness of the baby.We attached the complete report given by the life cell. Please guide us.Presently baby looks healthy.
Submitted:
4 Days
Category:
Pediatrician
Dear parent,
Thank you for your query at DoctorSpring.com
I can understand your concerns.
Firstly, all mothers as part of the antenatal screening are tested for toxoplasmosis, rubella, CMV, Herpes and Syphilis. This is a standard of care and am assuming that your wife had underwent the tests. Can you please provide those reports?
Secondly, the attached Life cell certificates are showing up blank when downloaded. Will appreciate it if you can check the same and resend the files.
Thirdly, if it is indeed IgG positivity, we need to see if it is a recent infection or an old infection. If it is an old infection, her IgG done during early pregnancy must also have been positive. If that IgG test is negative and now it has turned positive, then it means that the infection is recent. In that case, we need to get IgM of both mother and baby to rule out any recent infection in the mother and transmission to baby. We may also need to get quantitative CMV DNA PCR test of the baby. Baby also needs an ultrasound or CT head with assessment of hearing.
Regards
Dr. Saptharishi L G
Sir, I attached the documents. what will indicate by CT head or ultrasound. The tests on my wife ( mother) all the tests are -ve before predelivery. whether the quantitative CMV DNA PCR test is to be performed immediately or it can be done later also.Because my wife and baby is in remote village with my in-laws, I just want to know the severity and the requirement.
What is reason for these CMV IgG -POSITIVE in mother..Normally what are the causes it can happen..
whether any special medicine or treatment is required for baby if she is positive for CMV.please help we are bit scared..how it will effect my baby in longterm.
Thanks in advance
A Sandeep
Dear Mr. Sandeep,
Please understand that medicine is not mathematics. Not everything is absolutely straightforward. But, let me simplify this for you.
Cytomegalovirus is called CMV in short. This infection in adults is usually asymptomatic and can be acquired by anyone. You could be positive for it without even knowing it. It does not produce any symptoms or harm to immunocompetent adults. But, if acquired during pregnancy, it can get transmitted to the fetus and cause damage to baby's brain and hearing. Such infected babies are usually small for age (weigh less at birth) and may be born prematurely.
Now, to simplify the testing process:
CMV Acute infection --> IgM positive
CMV Old infection --> IgG positive
To check for the presence of virus (active infection) --> CMV DNA PCR
Cord blood being positive for IgG means that mother has had a CMV infection in the past.But, you cannot know when? If her antenatal CMV IgG was negative, then it is likely that she has acquired the infection during pregnancy only. This means that you need to get the following tests done as soon as possible (urgently):
1. Mother's CMV IgM
2. Baby's CMV IgM
3. Baby's CMV DNA PCR - quantitative viral copies
4. Baby's CT Head (for periventricular calcifications)
5. Baby's hearing test (for sensor-neural hearing loss)
If the above tests are suggestive, then your baby needs to be treated with IV Ganciclovir for perinatal or antenatal CMV infection.
Regards
Dr. Saptharishi L G
Dr. Saptharishi L G
DM (Pediatric Critical Care) Senior Resident
MBBS, MD (Pediatrics), PGDCRL
Division of Pediatric Critical Care